Individual
SEUNG J YO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11445 SUNSET HILLS RD, RESTON, VA 20190-5276
(703) 709-1500
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101225839
VA
2085R0202X
Diagnostic Radiology Physician
D0060078
MD
2085R0202X
Diagnostic Radiology Physician
MD039182
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405175100
—
MD
01
—
60234801
BLUE SHIELD
MD
01
—
80430037
BLUE SHIELD
DC
Enumeration date
07/17/2006
Last updated
02/07/2022
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